ECG Rhythm Interpretation

Module I

ECG Basics
 Course Objectives

To recognize the normal rhythm of the

heart - Normal Sinus Rhythm.
To recognize the 13 most common
rhythm disturbances.
To recognize an acute myocardial
infarction on a 12-lead ECG.
 Learning Modules

ECG Basics
How to Analyze a Rhythm
Normal Sinus Rhythm
Heart Arrhythmias
Diagnosing a Myocardial Infarction
Advanced 12-Lead Interpretation
Normal Impulse Conduction
Sinoatrial node

AV node

Bundle of His

Bundle Branches

Purkinje fibers
Impulse Conduction & the ECG
Sinoatrial node

AV node

Bundle of His

Bundle Branches

Purkinje fibers
The PQRST

P wave - Atrial
depolarization

QRS - Ventricular
depolarization
T wave - Ventricular
repolarization
 The PR Interval
Atrial depolarization
+
delay in AV junction
(AV node/Bundle of His)

(delay allows time for the

atria to contract before
the ventricles contract)
 Pacemakers of the Heart

SA Node - Dominant pacemaker with an

intrinsic rate of 60 - 100 beats/minute.
AV Node - Back-up pacemaker with an
intrinsic rate of 40 - 60 beats/minute.
Ventricular cells - Back-up pacemaker
with an intrinsic rate of 20 - 45 bpm.
 The ECG Paper

Horizontally
One small box - 0.04 s
One large box - 0.20 s
Vertically
One large box - 0.5 mV
 The ECG Paper (cont)
3 sec 3 sec

Every 3 seconds (15 large boxes) is

marked by a vertical line.
This helps when calculating the heart
rate.
NOTE: the following strips are not marked
but all are 6 seconds long.
End of Module I

ECG Basics